Use of robotic Telepathology for frozen-section diagnosis: A retrospective trial of a telepathology system for intraoperative consultation

Telepathology is the practice of digitizing histological or macroscopic images for transmission along telecommunication pathways for diagnosis, consultation, or continuing medical education. Previous studies have addressed static versus dynamic imaging in several specimen types with a wide variety of systems and communication pathways. The goal of this paper was to assess the validity of a Web-based telepathology system for frozen section consultation within the Army Medical Department. The system provides real-time, dynamic remote control of a robotic microscope over standard Internet connections. Oftentimes, a solo pathologist is called on to provide diagnostic services without the support of immediate second or expert consultation during an intraoperative consultation. The use of telepathology is attractive because it provides an opportunity for pathologists to obtain immediate consultation. For purposes of the study, 120 consecutive frozen section cases were diagnosed at a distance using the system. Intraobserver agreement between the telepathology diagnosis and glass slide diagnosis was observed. Diagnostic agreement was 100% for a wide variety of specimens. This study suggests that such a system will help support pathologists located at distant sites.